從全民健保資料分析糖尿病病患之流行病學與用藥情形

Analysis of Diabetes Mellitus Patients in Taiwan from Cohort Data of NHI

高建仁(Chien-Jen Kao) ； 高東煒(Dung-Wei Kao) ； 陳永煌(Yeong-Hwang Chen) ； 周稚傑(Chih-Chieh Chou) ； 劉紹興(Saou-Hsing Liou) ； 羅慶徽(Ching-Hui Loh)

《中華職業醫學雜誌》 12卷3期 (2005/07) Pp. 187-195

https://doi.org/10.30027/CJOM.200507.0007

摘要

研究目的：藉著分析全民健保資料之世代追蹤檔，來探討國人糖尿病流行病學以及用藥情形，並比較不同年齡層與性別間的差異。
研究方法：本研究資料來自國家衛生研究院所提供之全民健保研究資料，對象為20萬人之抽樣歸戶檔，期間為二OO二年之資料,病人為接受糖尿病治療之民眾。針對性別與年齡層等自變項，對各種類型的降血糖藥物，門診申報處方箋型態及相關性，進行描述性分析。
研究結果：在資料收集期間共獲得180,465位有效之病患樣本，其中有4,963人使用降血糖藥物。各類降血糖藥物所佔比例如下：
胰島素分泌刺激劑(Insulin secretagogue)：如Sulfonylureas類，佔87.48%、Glinide類，佔1.04%；胰島素增敏劑：Biquanides類，佔59.60%、Thiazolidinediones(TZD)類，佔0.36%；醣類分解酶的抑制劑(Alpha-glucosidase inhibitor)，佔1.65%。而男性患者用藥比率：sulfonylureas類佔89.88%，Biquanides類佔59.70%，Alpha-glucosidase inhibitor佔1.16%，Glinide類佔1.08%，Thiazolidinediones(TZD)類佔0.51%；女性則分別為85.72%、59.73%、2.08%、1.02%及0.22%。
結論：糖尿病患者的年齡層與性別差異，往往影響到降血糖藥物的選擇。適當的治療模式對整體預後相當重要，所以臨床醫護人員在面臨糖尿病患者時，應該適當地選擇適當的用藥，以避免造成多餘的醫療資源浪費。

關鍵字

門診 ； 糖尿病 ； 全民健保 ； 口服降血糖藥物

並列摘要

Purpose: To explore the demographic characteristics and medication patterns of diabetes mellitus in Taiwan from the sampling cohort data of National Health Insurance. Differences among age groups and gender are also analyzed.
Method: To facilitate research of National Health Insurance, National Health Research Institute released series of sampling cohort data, each cohort set containing 50 thousands beneficiaries. We pooled four sets of cohort data in the year 2002. Inclusion criteria were patients had the diagnosis of diabetes mellitus and prescribed with oral hypoglycemia agents. Descriptive analysis was performed to investigate the distribution of oral hypoglycemia agents among age groups and gender.
Results: There were 4,963 diabetes patients out of 180,465 beneficiaries in this analysis. The distributions of oral hypoglycemia agents were the followings: insulin secretagogue (e.g. sulfonylureas), 87.48%; insulin sensitizers (e.g. biquanides), 59.60%; glinides, 1.04%; thiazolidinediones (TZD), 0.36%; alpha-glucosidase inhibitors, 1.65%. For males and females, the distributions were sulfonylureas 89.88% and 85.72%; biquanides 59.70%, 59.73%; alpha-glucosidase inhibitors 1.16%, 2.08%; glinides 1.08%, 1.02%; thiazolidinediones (TZD) 0.51%, 0.22% respectively.
Conclusion: Medications of diabetes mellitus were different in different patients genders and ages. Treatment protocols were under investigation. Prescription of oral hypoglycemic agents should be tailored to patients ages and genders.

並列關鍵字

diabetes mellitus ； national health insurance ； oral hypoglycemic agents ； outpatient